Behind Victoria’s decision to open primary schools to all students: report shows COVID transmission is rare



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Fiona Russell, University of Melbourne; Edward Kim Mulholland, Murdoch Children’s Research Institute; Kathleen Ryan, Murdoch Children’s Research Institute; Kathryn Snow, University of Melbourne; Margie Danchin, Murdoch Children’s Research Institute, and Sharon Goldfeld, Murdoch Children’s Research Institute

At the weekend, Victorian Premier Dan Andrews announced all the state’s primary school kids would return to school for Term 4. This is an update from the previously planned staggered return to primary school, which would begin only with students in the early years — prep (first year) to Year 2.

The change was informed by our analysis of Victorian health and education department data on all cases and contacts linked to outbreaks at schools and early childhood education and care services (childcare and preschool).

We included data between January 25 (the date of the first known case in Victoria) and August 31.

Our analysis found children younger than 13 seem to transmit the virus less than teenagers and adults. In instances where the first case in a school was a child under 13, a subsequent outbreak (two or more cases) was uncommon. This finding played a key role in helping make the decision for primary school children to return to school.

Here is what else we found.

1. Outbreaks in childcare and schools are driven by community transmission

Infections linked to childcare, preschools and schools peaked when community transmission was highest in July, and declined in August. In addition, they were most common in the geographical areas where community transmission was also high.

This suggests infections in childcare, preschools and schools are driven primarily by transmission in the broader community. Controlling community transmission is key to preventing school outbreaks.

2. School infections are much lower than in the community

There were 1,635 infections linked with childcare, preschools and schools out of a total of 19,109 cases in Victoria (between January 25 and August 31).

Of 1 million students enrolled in all Victorian schools, 337 may have acquired the virus through outbreaks at school.




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Of 139 staff and 373 students who may have acquired infection through outbreaks at childcare, preschools or schools, eight (four staff and four students) were admitted to hospital, and all recovered.

The infections in childcare, preschools and schools were very rarely linked to infections in the elderly, who are the most vulnerable to COVID-19.

3. Most infections in schools and childcare centres were well contained

Of all the outbreaks in Victorian childcare centres, preschools and schools, 66% involved only a single infection in a staff member or student and did not progress to an outbreak. And 91% involved fewer than ten cases.

Testing, tracing and isolation within 48 hours of a notification is the most important strategy to prevent an outbreak.

The majority of infections in childcare, preschools and schools were well contained with existing controls and rapid closure (within two days), contact tracing and cleaning.




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4. Households are the main source of infection, not schools

The investigations of cases identified in schools suggest child-to-child transmission in schools is uncommon, and not the primary cause of infection in children. Household transmission has been consistently found to be the most common source of infection for children.

Closing schools should be a last resort

Based on our findings and a review of the international literature, we recommend prioritising childcare centres, preschools and schools to reopen and stay open to guarantee equitable learning environments — and to lessen the effects of school closures.

Children do transmit the virus and outbreaks can occur. But based on the international literature, this mostly happens when there are high rates of community transmission and a lack of adherence to mitigation measures (such as social distancing) at the school or childcare centre.

Childcare centres, preschools and schools play a critical role not only in providing education, but also offering additional support for vulnerable students.

With childcare centres and schools being closed, along with the additional economic and psychological stress on families, family conflict and violence has increased. This has led to many children and young people feeling unsafe and left behind in their education and suffering mental-health conditions.

Closing all schools as part of large-scale restrictions should be a last resort. This is especially the case for childcare centres, preschools and primary schools, as children in these age groups are less likely to transmit the virus, and be associated with an outbreak.

Now that community transmission in Victoria is so low, it’s time for all kids to go back to school.




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The authors would like to thank their advisory committee from the Department of Education and Training and the Department of Health and Human Services. They would also like to thank outbreak epidemiologists at the DHHS and medical students Alastair Weng, Angela Zhu, Anthea Tsatsaronis, Benjamin Watson, Julian Loo Yong Kee, Natalie Commins, Nicholas Wu, Renee Cocks, Timothy O’Hare, and research assistant Kanwal Saleem, and Belle Overmars.The Conversation

Fiona Russell, Principal research fellow, University of Melbourne; Edward Kim Mulholland, Professor, Murdoch Children’s Research Institute; Kathleen Ryan, Research Fellow, Asia-Pacific Health, Infection and Immunity Theme, Murdoch Children’s Research Institute; Kathryn Snow, Epidemiologist, University of Melbourne; Margie Danchin, Associate Professor, University of Melbourne, Murdoch Children’s Research Institute, and Sharon Goldfeld, Director, Center for Community Child Health Royal Children’s Hospital; Professor, Department of Paediatrics, University of Melbourne; Theme Director Population Health, Murdoch Children’s Research Institute

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Vale Susan Ryan, pioneer Labor feminist who showed big, difficult policy changes can, and should, be made



Susan Ryan in 1984, the first woman to be appointed to cabinet in a Labor government.

Chris Wallace, University of Canberra

The politician who achieved equal rights legislation for women in Australia, Hon Susan Ryan AO, died unexpectedly yesterday in Sydney aged 77, still fighting for fairness in a country challenged by deep inequalities.

In 1983, new Prime Minister Bob Hawke appointed Ryan Minister for Education and Youth Affairs and Minister Assisting the Prime Minister for the Status of Women. She was the first woman to be appointed to cabinet in a Labor government.

Rivalled only by the achievement of voting rights for women earlier in the 20th century, the Sex Discrimination Act Ryan created and saw through parliament was the single biggest step forward for women in Australian history.




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Ryan was a wry, intelligent, witty and energetic force for good in public life. She rose to the biggest policy challenges besetting Australia – inequality and discrimination – and achieved real change.

She brought brains and spirit to the big fights and relished them. Not for Ryan any slinking to the sidelines, crushed by sledges and slights.

The first time I saw her was at a party in 1983, in the Old Parliament House office of her Hawke Government cabinet colleague, Peter Walsh. Here they led a raucous wine-fuelled rendition of a Catholic hymn, followed by an equally spirited version of The Internationale. Ryan was from a generation of politicians who knew how to fight, have fun and get really important things done.

Born in Maroubra in 1942, Ryan was educated at the Brigidine School where she absorbed the lesson that “St Brigid was the equal of St Patrick, she worked with him in partnership”. It was here she registered too that:

… women were as clever, energetic and knowledgeable as men (but) society at large and the Church placed women in an inferior position and fought hard to keep us there.

Ryan was the first in her family and school to win a scholarship to the University of Sydney. She studied education, expecting to go on to a career in teaching. After graduating she married public servant and later diplomat Richard Butler. “Because of this I lost my scholarship and had to pay back the scholarship money,” Ryan recalled, a penalty not suffered by men in the same position.

In 1965, Ryan and Butler moved to Canberra and the next six years saw Ryan study for an MA in English Literature at the Australian National University, tutor at the Canberra College of Advanced Education (now University of Canberra), and become a founding member of the Belconnen Branch of the ALP.

This was interrupted by two periods living overseas when Butler was posted first to Vienna and then, in the early 1970s, to New York just as the foundational texts of second-wave feminism by Kate Millett, Gloria Steinem and others, primed by earlier work by Betty Friedan, were published. Ryan’s fellow Sydney University alumna Germaine Greer’s The Female Eunuch was part of the mix too, giving Ryan and her peers revolutionary insights into the outrageous injustices permeating their lives as women.

Ryan returned to Canberra in 1971 with their two children but without Butler, whom she divorced the following year. Her energetic, entwined Women’s Electoral Lobby (WEL) and ALP activism were conducted while completing her ANU masters degree and being employed as head of the Australian Council of State School Organisations.

Ryan worked hard for the Whitlam government’s election in 1972. Two federal elections later, at the “Dismissal” election of December 1975, she was elected a Labor senator for the ACT. When Bill Hayden succeeded Gough Whitlam as opposition leader after the 1977 election, he made Ryan Labor’s first ever woman frontbencher with responsibility for communications, the arts, media and women’s affairs.

Focused intently on the development of high-quality policy, Ryan was on the progressive end of the Labor party and impatient with its left/right factional battles, which she perceived as more about personal power struggles than genuine differences over ideas.

Ryan joined the Hayden-led Centre Left faction, home of federal parliamentary Labor’s sophisticated policy thinkers who modernised the ALP platform in a progressive direction focused on jobs and social justice.

These policies were embraced and implemented by the Hawke government on its election in March 1983, with tremendous success.

Susan Ryan devoted her post-parliament life to rights for the aged, especially for older women.
AAP/Lukas Coch

Ryan was initially sceptical of the virtues of Bob Hawke over Hayden as Labor leader and she, like Paul Keating whose dynamism she admired and with whom she shared a deep mutual respect, switched camps late.

Ryan nevertheless came to admire Hawke’s leadership, which culminated in the 1983 victory and three subsequent election wins. With Paul Keating’s 1993 election win, this gave Labor five consecutive terms of government in what it retrospect has come to be seen as a golden age in postwar social democratic politics and policy in Australia.

Within three months of the government’s election, Ryan introduced the Sex Discrimination Bill, which drew heavily on a private member’s bill she pursued unsuccessfully from the opposition benches in 1981. The bill was controversial and its passage rocky. Ryan fought the good fight and won.

Ryan’s work as a spearhead for progressive policy took its toll. As the government wrestled with economic policy adjustments necessitated by Australia’s current account crisis in the mid-1980s, she left politics after just five years in cabinet. Her post-parliamentary life saw her focus on superannuation policy and rights for the aged, especially for older women.

Ryan’s contribution to public life was outstanding. She was happy with the reality of her achievements and did not look for credit or applause. She is a signal example to those who despair of getting things done in democratic politics. Ryan showed, even on the most controversial issues, it can and should be done.




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The Conversation


Chris Wallace, Associate Professor, 50/50 By 2030 Foundation, Faculty of Business Government & Law, University of Canberra

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Curfew lifted and COVID-19 roadmap is ‘ahead of schedule’ as Melbourne inches towards end of lockdown


Stephen Duckett, Grattan Institute

Victorian Premier Daniel Andrews has announced an end to the curfew and a COVID-safe return to work for 127,000 Melburnians, as restrictions ease at 11.59pm tonight. He has also flagged a provisional early lifting of many other aspects of the lockdown on October 19.

The downward trend in new COVID-19 cases has been better than expected, with the crucial 14-day moving average of daily new cases reaching 22.1. This is good news for Victorians, prompting Andrews to move metropolitan Melbourne to the second step of the state’s roadmap to COVID-normal.

According to the roadmap, today’s announcement was contingent on the 14-day rolling average being below 30-50 cases. The 50-case mark was passed on September 17, and the lower bound of 30 cases was reached a week later, on September 24.

Graph of Victoria's COVID-19 cases

covid19data.com.au

Rather than easing restrictions when the criterion for new cases was met, the government had also, unnecessarily, set a date for moving to the second step: September 28.

Before today’s announcement, the better-than-expected decline in case numbers, coupled with the reduction in the number of “mystery” cases with an unknown source, had led Andrews to flag the possibility of easing restrictions faster than the provisional dates in the roadmap.

This is indeed what he has announced, with the next step potentially moving forward from October 26 to October 19. The government will now rely predominantly on epidemiological thresholds rather than dates. But Andrews added it is necessary to monitor the effects of today’s announcement for a further three weeks.

Andrews and his advisors had to keep in mind the ultimate goal of reaching zero active cases. Lifting restrictions too soon would jeopardise that.




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The main changes are cautious ones, and still consistent with the zero target. The key changes are shown below.



One of the most welcome changes will be the abolition of the curfew. It had no real evidence base, given the other restrictions in place, and it became a policy orphan with no one owning up to recommending it.




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The other major change is to formalise the return of on-site schooling. The research evidence on schools is complex, with different countries adopting very different rules about whether children can attend. But evidence suggests transmission risk is lower for kids under ten, so primary school return is welcome.

The return of VCE and VCAL students is presumably based on the assumption older teenagers should be able to follow physical distancing guidelines.The Conversation

Stephen Duckett, Director, Health Program, Grattan Institute

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Victorian Health Minister Jenny Mikakos quits, lashing out at Daniel Andrews



AAP/James Ross

Michelle Grattan, University of Canberra

Victoria’s health minister Jenny Mikakos has resigned, pointing the finger at Premier Daniel Andrews’ evidence that hung her out to dry in the hotel quarantine inquiry on Friday.

Mikakos said in a Saturday statement she will also quit parliament.

She said she never wanted to leave a job unfinished but in light of Andrews’ statement to the inquiry “and the fact that there are elements in it that I strongly disagree with, I believe that I cannot continue to serve in his Cabinet”.

“I am disappointed that my integrity has sought to be undermined. I know that my statement [to the inquiry] and evidence would have been uncomfortable for some.”

Andrews told the inquiry in his written statement that after an April 8 cabinet meeting, Mikakos was in charge of the hotel quarantine program, in which private security guards were used. This program went horribly wrong when COVID got out, triggering Victoria’s second wave. Andrews, Mikakos and other witnesses have all said they do not know who made the decision to use private guards.

Andrews said: “At the start of the program, I regarded Minister Mikakos and Minister Pakula as responsible for informing cabinet about, and seeking cabinet’s endorsement of, the initial overall service model and costings that had been determined for the program. They did so at the Crisis Council of Cabinet meeting on 8 April 2020.

“I then regarded Minister Mikakos as accountable for the program. The CCC was provided with regular reports by Minister Mikakos containing data relevant to Victoria’s response to the public health emergency, key insights from the data, as well as other updates, including in relation to the program.”

Mikakos, in her statement posted on Twitter, said: “For 3 months I had looked forward to learning who made the fateful decision to use security guards. Victorians deserve to know who.”

She said she had never shirked her responsibility for her department “but it is not my responsibility alone”.

“As I said to the Board of Inquiry, I take responsibility for my department, the buck stops with me. With the benefit of hindsight, there are clearly matters that my department should have briefed me on. Whether they would have changed the course of events only the Board and history can determine,”

“I look forward to the Board of Inquiry’s final report.”

Mikakos said she was “deeply sorry” for the situation Victorians found themselves in. “In good conscience, I do not believe that my actions led to them.”

On Thursday she told the inquiry she was “not at all” involved in the decision to use private security guards, and “I do not know who made that decision”. She said she didn’t know private security guards were being used until late May after a COVID outbreak at Rydges, almost two months after the program started.

“I can‘t imagine why it [the use of private security guards] would be brought to my attention, because […][the Department of Jobs, Precincts and Regions] held the contracts with the security companies,” she said.

But her evidence immediately came into question, because she had been at a press conference in late March when the use of private security was confirmed, and private security was mentioned in a briefing note for caucus on April 8. In a statement to the inquiry on Friday, Mikakos denied misleading it.

Andrews announced at a news conference on Saturday afternoon that the Mental Health Minister, Martin Foley, will replace Mikakos as health minister.

Andrews said Mikakos had taken the “appropriate course” in resigning. But he said he had not spoken to her beforehand – or since. She has texted him that she had sent a letter to the governor, of which he was already aware.

NSW Health Minister Brad Hazzard said on Twitter:

But the Health Workers Union, which had called for Mikakos’ resignation earlier this week, welcomed her departure.

Andrews said Labor would aim to have a replacement for Mikakos in the upper house before parliament next meets. Labor’s national executive will formally determine who fills the seat because the state ALP is being federally administered at present.

There will also be a replacement in cabinet, drawn from the upper house.

Foley told the Andrews news conference he had nothing but confidence in the health department and its secretary.

Andrews said the latest Victorian COVID tally was 12 new cases, and he would be making a statement on Sunday about the easing of restrictions. He said there was no dramatic variation from the road map but there were a couple of areas where more could be done.The Conversation

Michelle Grattan, Professorial Fellow, University of Canberra

This article is republished from The Conversation under a Creative Commons license. Read the original article.

The new 15-minute test has potential, but standard tests are still the best way to track COVID-19


Katherine Gibney, The Peter Doherty Institute for Infection and Immunity; Deborah Williamson, The Peter Doherty Institute for Infection and Immunity, and Jodie McVernon, University of Melbourne

Testing remains a vital component of Australia’s success in managing COVID-19.

We need to diagnose people infected with SARS-CoV-2, the virus that causes COVID-19, as early as possible so they can be isolated from others and their contacts quarantined. Testing also helps us understand to what degree the virus is present in the population, so we can tailor public health measures accordingly.

If you’ve had a COVID-19 test, in all likelihood you received a PCR test. That’s the one with the throat and nose swabs, and is regarded as the “gold standard” in COVID-19 testing.

But now the Therapeutic Goods Administration (TGA) has approved a new kind of COVID-19 test, which can produce results in as little as 15 minutes, as opposed to a day or more for standard tests.

So is this new rapid test set to revolutionise COVID-19 testing in Australia? Not quite yet.

The traditional tests

Nucleic acid tests, or PCR tests, can detect ribonucleic acid (RNA) of SARS-CoV-2 from a day or two before symptoms start, and for a week or more afterwards, as symptoms resolve. Of course, some people will test positive without ever having symptoms.

PCR tests have been the backbone of SARS-CoV-2 testing worldwide. Because of the vast global experience with PCR tests and their high performance, they’re considered the most reliable COVID-19 test.

PCR tests require specialised laboratory equipment and trained scientists and technicians to test the specimens; processing and testing take several hours.

Since January, we’ve performed an astonishing 7.4 million SARS-CoV-2 PCR tests in Australia, which has needed a massive upscaling of capacity in laboratories nationally.

An illustration of SARS-CoV-2, the coronavirus that causes COVID-19.
PCR tests detect SARS-CoV-2 viral RNA.
Shutterstock

At times, demand for PCR testing has exceeded capacity, occasionally resulting in delays of up to several days in getting results back to patients. Meanwhile, laboratories swamped with COVID-19 tests may be limited in their capacity to perform their routine business, including diagnostic testing for other infectious diseases.

As people are required to isolate until they receive a negative test result and their symptoms resolve, these delays may come at a cost to the person waiting, their family, and the economy.

Recognising these costs may lead some people to choose not to be tested, Victoria has offered financial compensation for people without leave entitlements awaiting test results.

But delayed case confirmation also increases the time to identification and quarantine of contacts, undermining public health efforts.




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What can we expect from the antigen test?

Rapid antigen tests can diagnose COVID-19 in 15 minutes. They’re relatively inexpensive and require a swab from the nose.

These tests detect viral antigens, proteins on the surface of SARS-CoV-2. The immune system recognises these proteins as foreign, and responds by making antibodies to SARS-CoV-2 (“anti-gen” means antibody generator).

Antigen tests perform best early in the infection when the amount of virus in a person’s system is highest. For a person with symptomatic COVID-19, this would be in the first week of symptoms. So they only pick up current infections – unlike antibody tests, which can detect if a person was previously infected with SARS-CoV-2.

Four SARS-CoV-2 rapid antigen tests have been licensed for use in Australia in the past two months.

Unfortunately, rapid antigen tests for COVID-19 appear to be less sensitive than PCR tests, meaning they may give a negative result in someone who does actually have COVID-19. One of the recently licensed rapid antigen tests may give a false negative result in up to 18.3% of people with COVID-19 diagnosed by PCR.




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While a positive rapid antigen test result is more reliable, widespread use of these tests in asymptomatic people will result in some false positive results — that is, a positive test result in someone who doesn’t have COVID-19.

At this stage, national COVID-19 guidelines don’t include information on antigen tests. So a person with a positive antigen test would need to undergo a PCR test to be counted in Australia’s official COVID-19 case numbers.

Considering the pros and cons

We’re faced with a trade-off between the potential benefits of the rapid antigen tests — the ability to test larger numbers of people, consuming fewer laboratory resources, and quicker results — and the potential to miss a few cases because of the lower test sensitivity.

Despite the lower sensitivity, increasing testing rates might result in an overall net increase in the proportion of COVID-19 cases diagnosed, and therefore a public health benefit by preventing onward transmission from these cases.

One possible strategic use of these tests may be in screening people without symptoms to detect asymptomatic and pre-symptomatic infection that might otherwise go undetected. This could include people in workplaces where ongoing exposure to colleagues and the public is unavoidable, including sectors of the food supply chain or other essential services.




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Because of the lower test sensitivity for the rapid antigen test, a PCR test remains most appropriate for people with symptoms, those at greater risk of poor outcomes from COVID-19, and people working in high-risk settings like aged care and health care.

While rapid antigen tests show promise, we’ll need to evaluate their efficacy in Australia before we can determine their role in our fight against COVID-19.The Conversation

Katherine Gibney, NHMRC early career fellow, The Peter Doherty Institute for Infection and Immunity; Deborah Williamson, Professor of Microbiology, The Peter Doherty Institute for Infection and Immunity, and Jodie McVernon, Professor and Director of Doherty Epidemiology, University of Melbourne

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Vital Signs. Google shouldn’t subsidise journalism, but the government could



Jeff Chiu/AP

Richard Holden, UNSW

You might have missed it – what with the biggest recession since the 1930s and a pandemic going on – but there may be big, and bad, changes happening to a media landscape near you.

Right now the Australian government is considering amending the Competition and Consumer Act 2010 to force Google and Facebook to pay local commercial media organisations for the sharing of their content on the digital platforms.

The News Media and Digital Platforms Bargaining Code proposed by the Australian Competition and Consumer Commission will require the tech and media companies to make terms through “mandatory binding arbitration”. It will also oblige them to divulge parts of their core intellectual property (such Google’s search algorithm).

It has been lauded as a world-first in addressing the power imbalance between the platforms and traditional news organisations.

Champions such as commission chief Rod Sims argue it’s a simple matter of forcing Google and Facebook to pay a fair price for extracting value from journalism for which they pay nothing. As Sims put it:

What this was all about was the imbalance in bargaining power, the market failure that comes from that, and underpayment for news having a detrimental effect on Australian society.

Who could argue with that? Even federal treasurer Josh Frydenberg has described it as “a question of fairness”.

But from an economic standpoint the whole bargaining code is hopelessly confused. It fails to properly understand the source of competitive pressure for media companies, and why they have lost revenues over the last 15 years.

Mandatory binding arbitration between tech and media companies is also a completely inappropriate policy tool to achieve the public policy goal of fostering high-quality journalism.

As I have written about in detail for the Stigler Center at the University of Chicago Booth School of Business, making the code law risks doing serious harm to Australian consumers while shovelling money to large media companies like Nine Entertainment and News Corp Australia.

Faced with the prospect of having to divulge key intellectual property, it would not be surprising if Google and Facebook simply prefer not to be in the Australian market. Millions of Australians using Google, YouTube and Facebook will lose out.

Media revenue sinking

Between 2002 and 2018, consulting firm AlphaBeta estimates total annual revenue for Australian newspapers fell from A$4.4 billion to A$3.0 billion. Almost all of this was due to lost classified advertising revenue, worth A$1.5 billion in 2002 but just A$200 million in 2018.

“That’s Google’s fault,” you might cry.

Actually no. The vast bulk of lost classified advertising revenue was due to online “pure-plays” such as Seek, Domain and Carsales. Google and Facebook took basically none of this revenue.




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The media companies were sitting on a gold mine of classified advertising. Then there was massive technological disruption due to the internet and smart phones.

That, as they say in the classics, is show business.

It doesn’t justify making companies who happened to succeed in an adjacent space at the same time fork over a chunk of their revenues.

But aren’t tech companies ‘stealing’ content?

If big tech companies were somehow allowing you and me free access to content we would otherwise have to pay for, there might be a case to answer.

That would be like Google Maps not only giving you directions to a restaurant but the means to also avoid paying for your meal.

But using a search engine does not allow you to get free meals, nor to get around a news organisation’s pay wall.




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In fact, having their content pop up in search results, or shared on social media, helps Australian media companies to attract readers and sell subscriptions – something that now accounts for roughly half the revenues of some leading players such as The Australian.

All you get for “free” is a snippet of a line or two from the search.

For instance, when I searched for news about recently deceased US Supreme Court Justice Ruth Bader Ginsburg, I got this:

If you can figure out the full content of the article from that snippet, you should be using your superpowers for other, more lucrative purposes.

Beware the politics

There is a very real risk this misguided code will end up becoming law.

An overzealous regulator has proposed something that stands to benefit the big media companies, who are – not surprisingly – strongly for it.

Those same media companies have huge influence over public perceptions and the fate of politicians. It will be a brave elected representative who pushes back on the proposed code and draft legislation.

But if politicians were serious about resolving the real issue at stake in all of this, they would act more directly.

Like newspapers all around the world, Australian media and journalists are under pressure – and one thing most people agree on is that high-quality news and journalism is critical to a well-functioning democracy.




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Whatever the market forces that have slashed the funding of such journalism, there is a strong case for government intervention. But if the Australian government wants to subsidise high-quality journalism, it should do it itself.

With the 10-year bond rate less than 1%, it would cost the government just A$18 million a year to fund the interest bill on A$2 billion of media subsidies a year. That’s 72 cents per Australian a year.

And all without driving away the hugely valuable services of companies like Google and Facebook that Australian consumers love.The Conversation

Richard Holden, Professor of Economics, UNSW

This article is republished from The Conversation under a Creative Commons license. Read the original article.

COVID-19 has offered us an unexpected opportunity to help more people quit smoking



Shutterstock

Simone Pettigrew, George Institute for Global Health

Smokers are worried. A respiratory disease is running rampant across the globe and people with unhealthy lifestyle habits appear to be especially vulnerable.

We know smokers hospitalised with COVID-19 are more likely to become severely unwell and die than non-smokers with the disease.

At any point in time, most smokers want to quit. But COVID-19 provides the impetus to do it sooner rather than later.

In our new study, we surveyed 1,204 adult smokers across Australia and the United Kingdom. We found the proportion intending to quit within the next two weeks almost tripled from around 10% of smokers before COVID-19 to 29% in April.

Many more were thinking about quitting some time soon, and most wanted help to do so.

Our research shows many people who smoke understand they can reduce their COVID-19 related risk by addressing their smoking. Given this, and the broader health gains associated with stopping smoking, we must ensure people who want to quit in the face of COVID-19 are supported.




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Information and support

When asked whether they’d like to receive information about the risks of COVID-19 for smokers, almost half (45%) of our respondents said they would. This was especially the case among those wanting to quit very soon.

As for where they wanted to get this information, participants most commonly chose government representatives (59%) and doctors (47%) as their preferred sources.

Television news was the most favoured information delivery channel (61%), followed by online news (36%), social media (31%) and email (31%).

A man smokes a cigarette outdoors.
We surveyed about 1,200 smokers in Australia and the UK.
Shutterstock

As well as being receptive to information, our participants were keen for support to help them quit.

Evidence-based forms of smoking cessation assistance include nicotine replacement therapy (for example, gum, patches and inhalers) and counselling.

Almost two-thirds (61%) of our respondents expressed an interest in receiving nicotine replacement therapy to help them quit, which rose to more than three-quarters (77%) if it could be home-delivered and provided free of charge.

Half (51%) wanted access to personal advice and support, such as that provided by Quitline. A similar number (49%) were receptive to being part of a text support program for smokers.

These results show us smokers are interested in forms of quitting assistance that can be delivered remotely. Making sure smokers know these sorts of things are available in lockdown could increase uptake, and in turn reduce smoking rates.

It’s also important to note the social isolation associated with the pandemic may make people more vulnerable to the addictive effects of nicotine. So they may need extra support during this time.

Two big risks to our health

Strong groundwork in the form of anti-smoking campaigns, tobacco taxes, and smoke-free environment legislation has reduced smoking levels in Australia to a record low of 11%. But even at this rate, smoking remains Australia’s number-one avoidable killer.

Smoking eventually kills up to two-thirds of regular users, and the number of people dying from smoking-related diseases still dwarfs COVID-19 deaths.

Roughly eight million people around the world die each year from tobacco-related diseases (such as cancer, stroke and heart disease), compared to the almost one million deaths attributed to COVID-19 so far.

Of course, the infectious nature of COVID-19 brings its own set of challenges. But combined, we have a potent reason to prioritise encouraging and helping smokers to quit as soon as possible.




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Does nicotine protect us against coronavirus?


There has been speculation about whether smoking increases the risk of contracting COVID-19, or whether nicotine might actually protect against the disease. The evidence remains unclear.

Regardless of whether smoking affects the risk of contracting COVID-19 in the first place, we know it increases the risk of dying from it. Providing intensive quit support during the pandemic could facilitate a substantial boost to cessation rates and bring us closer to the day when smoking becomes history.

Capitalising on this opportunity

Smokers’ increased risk from COVID-19 and the importance of encouraging smokers to quit to reduce their risk of a range of non-communicable diseases means health agencies around the world are sending messages about the importance of quitting now.

Our results suggest these statements should ideally be accompanied by explicit offers of help to quit in the form of nicotine replacement therapy and counselling. Investment in these is cost-effective, and now is an ideal time to make them as widely available and affordable as possible.

Many smokers would also likely benefit from the use of mass media to provide more information about their greater risk if infected with COVID-19.

This heightened interest in quitting in the face of COVID-19 — reflected not only in our research, but elsewhere — represents a unique opportunity for governments and health agencies to help smokers quit, and stay off smoking for good.




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Smoking at record low in Australia, but the grim harvest of preventable heart disease continues


Readers around Australia can call Quitline on 13 7848 or visit www.quit.org.au to access a free multi-session quit assistance program.The Conversation

Simone Pettigrew, Professorial fellow, George Institute for Global Health

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Is Malaysia heading for ‘BorneoExit’? Why some in East Malaysia are advocating for secession



FAZRY ISMAIL/EPA

James Chin, University of Tasmania

Unity is a common theme every year on Malaysia Day, the holiday celebrated last week that marks the day Malaysia became a federation in 1963.

That year, Britain agreed to relinquish control of most of its remaining colonies in Southeast Asia — Singapore, North Borneo (now called Sabah) and Sarawak. They then joined with Malaya, which had gained independence from Britain in 1957, to form a new nation called Federation of Malaysia.

The legal instrument to form the federation is called the Malaysia Agreement (MA63).

Yet, for the people of Sabah and Sarawak, located on the island of Borneo, the agreement left many with mixed emotions. Some people in these states have long desired secession and, in recent years, the drumbeat of separation has only grown louder.

This issue is now a key political issue in the Sabah state election this weekend and upcoming the Sarawak elections, which must be held before the end of 2021.

The two parts of Malaysia are separated by the South China Sea.
Shutterstock

Source of historical grievances

In a nutshell, most people in Sabah and Sarawak (also known as East Malaysia) are unhappy with federation because they think it has not delivered on two main promises made in 1962 — high levels of autonomy and economic development.

In the first area, the federal government has stripped away a lot of local powers in Sabah and Sarawak in the last 57 years. On top of that, the federal authorities have tried to impose the same toxic racial and religious politics found in Malaya (also known as West Malaysia) to the eastern states.

East Malaysia is much more ethnically and religiously diverse compared to the west. For example, the Malay population is a minority in both Sabah and Sarawak; in fact, no ethnic group constitutes more than 40% in either state. As a result, political Islam has not taken root here.




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In fact, one of the defining features of East Malaysia is intermarriage among the different ethnic and religious groups. The divide between Muslims and non-Muslims is reasonably insignificant — a marked difference from the often suspicious attitude Islamic leaders have toward non-Muslims in Kuala Lumpur.

In terms of economic development, Sabah remains one of the poorest states in Malaysia. And the infrastructure in both Sabah and Sarawak is vastly underdeveloped compared to the west of Malaysia.

To add insult to injury, more than half of Malaysia’s oil and gas production comes from Sabah and Sarawak. The common joke is that all the iconic infrastructure in peninsular Malaysia, such as the Petronas Towers, Penang Bridge and Kuala Lumpur international airport, was built with money from East Malaysia.

The infrastructure in Kuala Lumpur far exceeds that in Malaysia’s eastern states.
FAZRY ISMAIL/EPA

Britain’s hand in the federation

In recent times, one of the biggest grievances in East Malaysia comes from the process of decolonisation administered by the British after the second world war.

There is clear, documented evidence that back in 1962, the colonial office in London used its powers and influence to get the local leaders in Sabah and Sarawak to agree to the formation of Malaysia.

The British wanted a clean exit from Southeast Asia and to ensure its former colonies did not turn to communism. So the British conceived the idea of a “Federation of Malaysia”, where its former territories would come under a single political entity.

Activists in East Malaysia say if the British had not supported the formation of the federation, it was highly unlikely local leaders would have agreed to it. Many would have instead preferred independence or a federation consisting of Sabah, Sarawak and Brunei (which gained independence from Britain much later, in 1984).

A campaign event in Sabah ahead of this weekend’s elections.
Shutterstock

What Sabah and Sarawak want

All these historical grievances have led to a growing movement in Sabah and Sarawak advocating for secession from the federation.

With elections upcoming in both states, all local politicians — including those serving in the federal government — are now claiming to be MA63 nationalists trying to keep “Malaya out” of Sabah and Sarawak.

Social media is one key reason the secessionist movement has taken off in East Malaysia. It is now much easier for advocates to organise and magnify their grievances.

What the Sabah and Sarawak people want, at the very least, is a constitutional amendment to recognise the special autonomy of both states. But a significant minority argues the whole federation has failed, and thus secession is the only way forward.

Currently, the secessionist groups pose no real threat to the federation. But if enough people buy the secession argument in the future, public sentiment may be too strong for the national leaders to ignore.

How should the federal government respond?

There are basically two options available to the federal government.

The first is the ostensibly easy option — the political route. This would require the federal government to recognise the historical grievances and try to resolve them.

However, this is not as simple as it seems. The government is reluctant to grant real autonomy to the two states, worried this will end up weakening federal powers in the other 11 states of the federation.




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There was an attempt to reword the Constitution last year to symbolically recognise the special status of both states, but it failed.

This is the only way to keep the federation together, however. The federal leaders need to agree to recognise the special status of Sabah and Sarawak and grant them wide autonomy in the Constitution, as envisaged in the 1963 Malaysia Agreement.

The second option for the government is to play a wait-and-see game. Politically, this is dangerous, as the final outcome could very well be secession.

By way of comparison, the push for independence in Catalonia was similarly based on historical grievances that mushroomed into a mainstream political movement and eventually an independence referendum — declared illegal by Spain’s constitutional court.

At the very least, what is happening on the ground in East Malaysia suggests the decolonisation process in Southeast Asia is not yet complete. This colonial legacy is not merely history, but is clearly reflected in the present reality.The Conversation

James Chin, Professor of Asian Studies, University of Tasmania

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Frydenberg is setting his budget ambition dangerously low


Brendan Coates, Grattan Institute and Matthew Cowgill, Grattan Institute

Treasurer Josh Frydenberg’s announcement that he’ll prioritise reducing unemployment ahead of reducing government debt is welcome news.

The government is required by the Charter of Budget Honesty to develop and publish a fiscal strategy to be used in each budget.

The one that it has been using doesn’t mention unemployment at all and instead talks about offsetting new spending “by reductions in spending elsewhere” and commits it to “achieve budget surpluses, on average, over the course of the economic cycle” – something that’s not going to happen for a long time.

A realistic fiscal strategy is a good idea. A lot of behaviour is driven by expectations. If consumers and businesses think the government is going to slash and burn its way to a surplus, any stimulus in the meantime will be less effective.

People are more likely to save, and businesses less likely to hire, if they think tax hikes and spending cuts are around the corner.

A clear statement that is not the case will help.

But the Treasurer’s pledge to keep running deficits “until the unemployment rate is comfortably back under 6%” is nowhere near ambitious enough.

Former US Federal Reserve Chairman William McChesney Martin Jr. once famously said that the central bank’s role is “to take away the punch bowl just as the party gets going”.

Tightening budget policy – raising taxes or cutting spending – when unemployment crosses the 6% mark would be packing away the booze when many of the guests haven’t even arrived.

In the 15 years before COVID-19 struck, Australia’s unemployment rate had been above 6% only briefly, between mid 2014 and early 2016.


Unemployment rate, 2015 – 2019

Seasonally adjusted.
ABS Labour Force, Australia

The unemployment rate was well below 6% before the pandemic struck, yet the labour market was clearly running below its potential.

Before the pandemic, the Reserve Bank revised down its estimate of the unemployment speed limit – the unemployment rate at which inflation and wages would accelerate – from 5% to around 4.5%.

The Treasurer should wait until we’re closer to that speed limit before reaching for the brakes. The difference between 6% and 4.5% unemployment might not sound like much, but it amounts to an extra 200,000 people or so in work.

And it affects the rest of us too. Most Australians won’t get anything more than modest pay rises until the labour market tightens.

The danger is declaring victory too soon

The government handled the acute phase of this crisis well, although not perfectly. It deserves credit for moving very quickly to support the economy. But the danger now is that it turns too soon to budget tightening, stunting a nascent recovery.

This is the mistake many governments and central banks made after the global financial crisis – acting commendably to shore up activity in the crisis phase, but then pulling away support before enough of the damage had been repaired.

With interest rates so low, the government has a lot of capacity to run deficits without the debt-to-GDP ratio getting out of control.

As Frydenberg noted, “with historically low interest rates, it is not necessary to run budget surpluses to stabilise and reduce debt as a share of GDP — provided the economy is growing steadily”.




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It’s a point made by former IMF Chief Economist Olivier Blanchard in one of the most influential recent papers in economics – his 2019 presidential address to the American Economics Association.

Blanchard noted that when the interest rate on government debt is less than the nominal growth rate of the economy, “public debt may have no fiscal cost”.

We’ve access to money for nothing

The Australian government can borrow for 10 years at a fixed interest rate of about 0.9%. It recently issued 30-year fixed-rate bonds for less than 2%.

Both are less than the Reserve Bank’s inflation target, suggesting that over time in real terms the money will cost nothing.

Over the past five years, Australia’s nominal growth rate has averaged 4%. The most recent Intergenerational Report projected average nominal growth of 5.25% a year for 40 years.

Even if economic growth falls well short of that projection it is hard to imagine it going below the rate at which the government can borrow for very long.

That means debt is likely to remain manageable relative to the size of the economy, and debt servicing costs will be modest, particularly compared to the benefits of stimulus.




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Over the medium-term the government will need to ensure its debt is sustainable and does not continue to rise as a share of the economy.

But rushing too quickly to “repair” the budget position would be an economic ‘own goal’ – hampering job creation, economic growth, and ultimately the bottom line it sought to protect.

Reserve Bank Deputy Governor Guy Debelle said this week that “absent the fiscal stimulus, the economy would be significantly weaker and debt levels even higher”.

He is right. Taking the foot off the economic accelerator when unemployment is at 6% would condemn Australia to a long and slow recovery. It’s not in the Treasurer’s interest, and it’s not in ours.The Conversation

Brendan Coates, Program Director, Household Finances, Grattan Institute and Matthew Cowgill, Senior Associate, Grattan Institute

This article is republished from The Conversation under a Creative Commons license. Read the original article.

As a second wave of COVID looms in the UK, Australia is watching closely



Aaron Chown/AAP

Ben Wellings, Monash University

The United Kingdom has already been battered by COVID-19, with about 410,000 cases and more than 41,000 deaths.

But after some respite over summer — and entreaties to “Eat Out to Help Out” to boost the economy — the UK is now facing a terrifying second wave. This week, experts predicted almost 50,000 new cases a day by October if the current infection rate does not slow.

What does this mean for UK? And what is the significance for Australia as it watches on from the other side of the world?

New restrictions

This week, British Prime Minister Boris Johnson announced a new set of restrictions. These include early closures of pubs and restaurants, working form home if possible and wearing masks in shops.

As Johnson warned, if people don’t comply, a second lockdown is on the cards.

Since Johnson himself almost died of COVID in April, amid the UK’s disastrous first wave, international attention has been elsewhere. Not surprisingly, we have been looking instead to the United States, which has the highest number of deaths and is in the middle of an election.




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There are are also dire stories coming out of India, France, Spain and Indonesia. But unfortunately, it’s time to look to the UK once again.

The UK’s COVID experience so far

With more than 41,000 deaths, the UK has the highest COVID death toll in Europe.

Londoners in mask line up for a bus
Attention is once again on the UK and its COVID response.
Dominic Lipinski/AAP

So the UK’s relaxation of restrictions in July seemed counter-intuitive. While people in Britain have certainly enjoyed the summer sun, infections have once again climbed at an alarming rate.

The UK government’s policy choices can in part be explained by its hostility towards the public service. This is part of the so-called “Brexit revolution,” designed to shake up post-Brexit Britain.

This has seen decisions that suggest the government is choosing the evidence it likes, rather than what will best address the health crisis.




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Coronavirus: why aren’t death rates rising with case numbers?


The recently announced 10pm pub curfew, is a good example here — it is not clear that COVID only comes out late at night.

No one can doubt the difficult trade-offs required between health and the economy (although the two are much more linked than public debates suggest). But the government appears to favour economic needs and seems cavalier with the public health consequences.

Trust in government, essential during a public health crisis, has suffered accordingly. This was not helped when Johnson’s chief adviser, Dominic Cummings, broke the rules he helped set by travelling across England during lockdown.

Cummings survived this scandal, which is down to Johnson’s 80-seat majority, won during last year’s “Brexit” election.

Those watching Johnson’s erratic COVID-response take note: when governments command big majorities, they can ride out political crises.

The Conservatives and the pandemic

Of course, a pandemic is especially difficult terrain for the conservative side of British politics. Like its US counterpart, from which it takes many of its cues, government intervention is anathema.

For many Conservatives, personal freedom and individual liberty are expressed through a functioning market economy. The strength of this feeling is seen in the criticism of Johnson (and the new restrictions) in the UK’s influential right-wing press this week.

Sign, 'act now to avoid a lock lockdown'
UK Prime Minister Boris Johnson has warned a second lockdown is possible if COVID infections keep climbing.
Jon Super/AAP

But others of course do not think Johnson has gone far enough, with parts of England already in local lockdowns. Scotland has also taken a much clearer approach to the pandemic, mirroring policies adopted in Australia and New Zealand, further boosting support for independence.

What does this mean for Australia?

What happens to the UK during COVID is more than just a passing headline in Australia. A looming second wave will not make it easier for Australians stuck in the UK to come home.




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Stranded Australians are also just the tip of the iceberg. People-to-people relations between Australia and the UK remain hugely significant. As of 2018, 1.2 million people born in the UK were living in Australia.

The pandemic has also coincided with major geo-strategic shifts in both the UK’s relationship with the European Union and Australia’s relationship with China.

Britain has recently angered Europe further with new legislation that could ignore parts of its EU exit agreement.

But this does not affect Australia’s plans for a free trade deal with the UK, with talks there already underway.

Indeed, Australia and the UK now need each other more than they have for decades — despite their locations at opposite ends of the earth. The British even have former prime minister Tony Abbott as a UK trade envoy to help.

A tough winter ahead

The current infection rates — combined with questionable decision-making from the Johnson government — do not bode well for a possible second lockdown in England.

Pedestrians outside Waterloo Station in London
New UK restrictions could last for six months.
Dominic Lipinski/AAP

As Melburnians can attest, a second lockdown does not have the “we’re all in this together” feel of the first. For England, this means that the pseudo-Churchillian rhetoric and invocation of the wartime spirit will paper over the policy cracks even less.

Back in Australia, those people wanting to get to the UK will have to wait longer before such visits become possible. But given the increasing importance of both countries to each other, no doubt Australians and Britons will meet again some sunny day.The Conversation

Ben Wellings, Senior Lecturer in Politics and International Relations, Monash University

This article is republished from The Conversation under a Creative Commons license. Read the original article.